Organization
WORCESTER ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY MARLIN DMD (OWNER)
(508) 755-3636
Entity
Organization
Contact information
Practice address
255 PARK AVE, SUITE 303, WORCESTER, MA 01609-1953
(508) 755-3636
(508) 791-7245
Mailing address
255 PARK AVE, SUITE 303, WORCESTER, MA 01609-1953
(508) 755-3636
(508) 791-7245
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111580
UNITED CONCORDIA
MA
01
—
X11269
BLUE CROSS BLUE SHIELD
MA
Enumeration date
04/20/2007
Last updated
08/22/2020
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